gemcitabine and hodgkin's disease chemotherapy followed by peripheral blood stem cell rescue for hodgkin's disease

Conditions: Hodgkin Disease; Hodgkin's Lymphoma; Lymphoma

Summary: this is a phase 2 study of gemcitabine + high-dose chemotherapy followed by peripheral blood stem cell (pbsc) rescue for hodgkin's disease

to assess the non-hematologic toxicity and determine the phase 2 dose of gemcitabine in combination with vinorelbine followed by carmustine, etoposide and cyclophosphamide and autologous hematopoietic stem cell transplantation \[aka peripheral blood stem cell (pbsc)\].

Eligibility criteria:
inclusion criteria: * histologically-proven recurrent or refractory hodgkin's disease (hodgkin's lymphoma) on the basis of excisional biopsy whenever possible. * age \< 70 years * eastern cooperative oncology group (ecog) performance status 0 to 3. * phase 1 study component only: 1 or more of the following adverse risk factors * stage iv extranodal disease at relapse "b" symptoms * failure to achieve minimal disease with most recent chemotherapy (single lymph nodes \ 75% reduction in a bulky tumor mass and bone marrow involvement \< 10%) * progression during induction or salvage therapy * phase 2 study component only: no risk factor criteria * computerized tomography (ct) scan of the chest, abdomen and pelvis, with assessment of response to last chemotherapy, within 4 weeks of registration. gallium scan or positron emission tomography (pet) scan confirmation of disease within 4 weeks of registration is highly recommended * bone marrow biopsy and cytogenetic analysis within 8 weeks of registration * women of child-bearing potential and sexually active males expected to use an accepted and effective method of birth control * pretreatment serum bilirubin \< 2 x the institutional upper limit of normal (uln) (within 28 days prior to registration) * serum creatinine \< 2 x the institutional uln (within 28 days prior to registration) * measured or estimated creatinine clearance \> 60 cc/min by the following formula (within 28 days prior to registration): * estimated creatinine clearance = (140 age) x wt(kg) x 0.85 (if female) x creatinine (mg/dl) * electrocardiogram (ecg) demonstrating no significant abnormalities suggestive of active cardiac disease (within 42 days prior to registration) * patients over age 50, who have received chest irradiation or a total of 300 mg/m2 of doxorubicin or with any history of cardiac disease must have a radionuclide ejection fraction (within 42 days prior to registration). if the ejection fraction is 40 to 50%, the patient will have a cardiology consult * corrected diffusion capacity \> 55% * written informed consent in accordance with institutional and federal guidelines exclusion criteria: * positive hiv antibody test (must be conducted within 42 days of registration) * no chemotherapy other than corticosteroids should be administered within 2 weeks of the initiation of protocol therapy * pregnant * breast-feeding * requiring therapy for: * coronary artery disease * cardiomyopathy * dysrhythmia, or * congestive heart failure * over age 50 and has received chest irradiation or a total of 300 mg/m\^2 of doxorubicin * history of cardiac disease and the ejection fraction is \< 40% (radionuclide ejection fraction must be within 42 days of registration) * known allergy to etoposide * history of grade 3 hemorrhagic cystitis with cyclophosphamide * history of grade 2 or greater sensory or motor peripheral neuropathy due to prior vinca alkaloid use * no prior malignancy (exception: adequately treated basal cell or squamous cell skin cancer; in situ cervical cancer; or other cancer for which the patients has been disease-free for 5 years). patients with a prior diagnosis of non-hodgkin's lymphoma are not eligible.